NCG030020_Renewal COC Request_20181129 11:31:36 AM

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NORTH CAFOLINA
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Permit COC
NCG030020
Number *
Enter the Certificate of Coverage (COC) number, not the General Fbrmt number (e.g., NCGO30222 is the COC, not
NCG030000) M-ST BEGIN WTTH CAPITAL "NCG'
Name of Person
Dave Eblen
Obtaining COC*
First and LastNarre
Phone Number* 828-652-9308
Email * [e-mail]
The COC will be e-rrailed to this contact.
Additional Email [e-mail]
(Optional) Enter an additional email address to whom to send the COC
Please review the information below for accuracy before submitting. If there are inconsistencies, please
contact Bethany Georgoulias at [phone] or [e-mail].
M aste r Ge ne ral NCG030000
Permit No.
COC No.
NCG030020
Permittee
Haldex Brake Products Corp
Facility Name
Haldex Brake Products Corporation
Address
5334 US 221 S
City
Marion
County
McDowell
Waterbody
Muddy Creek
Classification
WS-IV
River Basin
Catawba
RENEWAL STATUS
Active
Issuance Date *
10/29/2018
Effective Date
11/01/2018
1 hereby request a copy of the Certificate of Coverage (COC) entered above. I understand that the COC e-mailed as a
result of this request will serve as the Permittee's record of renewed coverage under the General Permit, and that this
record must be maintained with the Permittee's NPDES Stormwater Permit records.
Signature *
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Date * 11 /29/2018